Older Patients’ Involvement in Shared Decision-Making—A Systematic Review

Anne Lise Holm,Elisabeth Severinsson,Astrid Karin Berland

doi:10.4236/ojn.2016.63018

Abstract

Shared decision-making has been described as allowing patients to gain more control over their life situation and feel less helpless. The aim of this systematic review was to describe the involvement of older patients in shared decision-making in community settings. In accordance with the systematic review method, a total of 2468 abstracts were read, after which nine quantitative studies were included. A qualitative thematic analysis was performed and two themes emerged; increased understanding of self-management and a desire to strengthen one’s position in relationship with professionals, both of which were essential for empowering older patients to participate in shared decision-making. Older patients’ shared decision-making was seen as a struggle to maintain their autonomy in different areas of everyday life. Emotional and psychological problems made their position more difficult. In order to empower them in relationships with healthcare professionals, older patients require more knowledge (self-efficacy) and information about their illness, which could strengthen their position in the decision-making process. They also need a greater awareness of decisional conflicts that may arise. Age, gender and health status influence older patients’ chance of being respected and taken seriously in relationship with professionals.

Highlights

The policy of the World Health Organization [1] is that users of community health services should be active par-How to cite this paper: Holm, A.L., Berland, A.K. and Severinsson, E. (2016) Older Patients’ Involvement in Shared Decision-Making—A Systematic Review
The authors of the present review investigated shared decision-making among community dwelling older persons by means of a qualitative thematic analysis, in which they identified, grouped and summarized the findings as described by Pope et al [43]
The results revealed two themes; increased understanding of self-management and A desire to strengthen one’s relationship with professionals, both of which were essential for empowering older patients to participate in shared decision-making

Summary

Introduction

The policy of the World Health Organization [1] is that users of community health services should be active par-How to cite this paper: Holm, A.L., Berland, A.K. and Severinsson, E. (2016) Older Patients’ Involvement in Shared Decision-Making—A Systematic Review. The policy of the World Health Organization [1] is that users of community health services should be active par-. (2016) Older Patients’ Involvement in Shared Decision-Making—A Systematic Review. During the past 35 years, health policies, educational curricula and institutional health organizations in the western world have highlighted active patient participation in healthcare decision-making [2]-[4]. Treatment and related decision-making is deemed desirable in health policies and forms part of legal rights movements in many western countries [5]. Many models of patient participation in decision-making aim to ensure that the patient’s voice is heard in healthcare decisions [8] [9]

Methods

Results

Discussion

Conclusion